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Elbow Instability: Anatomy, Biomechanics, Diagnostic Maneuvers, and Testing.

ABSTRACT: The elbow comprises a complex of bony and ligamentous stabilizers that provide both primary and secondary constraints to elbow instability. Through trauma and overuse, classic instability patterns arise by loss of these important stabilizers. The diagnosis of elbow instability can made using specific examination maneuvers and testing to diagnose the clinical pattern. This article reviews the elbow's unique anatomy and biomechanical characteristics and these are applied when reviewing the maneuvers and testing used to diagnose elbow instability.

SUBMITTER: Karbach LE

PROVIDER: S-EPMC5821063 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

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Elbow Instability: Anatomy, Biomechanics, Diagnostic Maneuvers, and Testing.

Karbach Lauren E LE Elfar John J

The Journal of hand surgery 20170201 2

The elbow comprises a complex of bony and ligamentous stabilizers that provide both primary and secondary constraints to elbow instability. Through trauma and overuse, classic instability patterns arise by loss of these important stabilizers. The diagnosis of elbow instability can made using specific examination maneuvers and testing to diagnose the clinical pattern. This article reviews the elbow's unique anatomy and biomechanical characteristics and these are applied when reviewing the maneuve ...[more]

PMID: 28160902

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Project description:BackgroundAn athlete who returns to sport after an anterior cruciate ligament (ACL) injury has a substantially high risk of sustaining a new secondary ACL injury. Because ACL injuries most frequently occur during cutting maneuvers, such movements should be at the center of research attention.PurposeTo investigate whether knee biomechanical parameters during side-step cutting maneuvers differ between female elite athletes with and without a history of ACL injury and to evaluate whether such parameters are associated with future secondary ACL injury.Study designCohort study; Level of evidence, 2.MethodsA total of 756 female elite handball and soccer players, of whom 76 had a history of ACL injury, performed a sport-specific cutting task while 3-dimensional kinematics and kinetics were measured. ACL injuries were registered prospectively over an 8-year follow-up period. Seven knee-specific biomechanical variables were the basis for all analyses. Two-way analyses of variance were applied to assess group differences, whereas logistic regression models served to evaluate associations between the knee-specific variables and future secondary ACL injury.ResultsWhen players with a previous ACL injury performed the cutting maneuver with their ipsilateral leg, they exhibited lower knee abduction angles (mean difference [MD], 1.4°-1.5°; 95% CI, 0.2°-2.9°), lower peak knee flexion moments (MD, 0.33 N·m/kg-1; 95% CI, 0.18-0.48 N·m/kg-1), lower peak knee abduction moments (MD, 0.27 N·m/kg-1; 95% CI, 0.12-0.41 N·m/kg-1), and lower peak knee internal rotation moments (MD, 0.06 N·m/kg-1; 95% CI, 0.01-0.12 N·m/kg-1) compared with injury-free players. When players performed the cut with their contralateral leg, no differences were evident (P < .05). None of the 7 knee-specific biomechanical variables was associated with future secondary ACL injury in players with an ACL injury history (P < .05).ConclusionApproximately 4 years after ACL injury, female elite team-ball athletes still unloaded their ipsilateral knee during cutting maneuvers, yet contralateral knee loading was similar to that of injury-free players. Knee biomechanical characteristics were not associated with future secondary ACL injury.

Dataset Information

Elbow Instability: Anatomy, Biomechanics, Diagnostic Maneuvers, and Testing.

Publications

Elbow Instability: Anatomy, Biomechanics, Diagnostic Maneuvers, and Testing.

Similar Datasets

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